Quantifying the burden of vampire bat rabies in Peruvian livestock

Background: Knowledge of infectious disease burden is necessary to appropriately allocate resources for prevention and control. In Latin America, rabies is among the most important zoonoses for human health and agriculture, but the burden of disease attributed to its main reservoir, the common vampire bat (Desmodus rotundus), remains uncertain. Methodology/Principal findings: We used questionnaires to quantify under-reporting of livestock deaths across 40 agricultural communities with differing access to health resources and epidemiological histories of vampire bat rabies (VBR) in the regions of Apurimac, Ayacucho and Cusco in southern Peru. Farmers who believed VBR was absent from their communities were one third as likely to report livestock deaths from disease as those who believed VBR was present, and under-reporting increased with distance from reporting offices. Using generalized mixed-effect models that captured spatial autocorrelation in reporting, we project 4.6 (95% CI: 4.4–8.2) rabies cases per reported case and identify geographic areas with potentially greater VBR burden than indicated by official reports. Spatially-corrected models estimate 505–724 cattle deaths from VBR in our study area during 2014 (421–444 deaths/100,000 cattle), costing US$121,797–171,992. Cost benefit analysis favoured vaccinating all cattle over the current practice of partial vaccination or halting vaccination all together. Conclusions: Our study represents the first estimate of the burden of VBR in Latin America to incorporate data on reporting rates. We confirm the long-suspected cost of VBR to small-scale farmers and show that vaccinating livestock is a cost-effective solution to mitigate the burden of VBR. More generally, results highlight that ignoring geographic variation in access to health resources can bias estimates of disease burden and risk. Author summary: The number of cases and monetary cost of a disease guides how resources for prevention and control are allocated. In Latin America, rabies transmitted by vampire bats is one of the most recognized zoonoses affecting humans and livestock, but its burden on lives and livelihoods has been difficult to calculate because the percentage of outbreaks that are not reported to surveillance systems is unknown. Here, using surveys to calculate farmers’ tendencies to report livestock deaths, we estimate that over 500 cattle died of rabies in southern Peru in 2014, a loss of approximately US$170,000 or over 700 months of local income. Our results also show that the perceived risk of rabies strongly affected reporting of cattle mortality and vaccination coverage, suggesting that campaigns to increase awareness could reduce the burden of rabies.